Provider Demographics
NPI:1275603524
Name:MCCONNELL, BARBARA SIEGEL (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:SIEGEL
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ELAINE SIEGEL
Other - Last Name:MCCONNELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3645 N BRIARWOOD LN STE A
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5337
Mailing Address - Country:US
Mailing Address - Phone:765-289-5520
Mailing Address - Fax:765-289-5840
Practice Address - Street 1:3645 N BRIARWOOD LN STE A
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304
Practice Address - Country:US
Practice Address - Phone:765-289-5520
Practice Address - Fax:765-289-5840
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003559A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN34003559AOtherPROFESSIONAL LICENSING AGENCY